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Urethrovaginal Fistula Show Comments PDF Print E-mail
  
  • Etiology
    • Usually post surgical (urethral diverticulectomy, anti-incontinence surgery, etc.)
    • Other:
      • Trauma
      • LUT instrumentation (catheterization)
      • Radiation
      • Child birth/obstetrical
  • Presentation
    • Often asymptomatic if located in the distal third of the urethra
    • If symptoms present then the presentation is similar to VVF
    • May present with symptoms suggestive of stress or urgency incontinence
      • In these cases cystourethrography will be necessary to make the diagnosis.
    • Dyspareunia
    • Recurrent urinary tract infections (UTls).
  • Evaluation
    • Voiding cystourethrography VCUG.
      • Voiding images must be obtained in patients with a competent bladder neck and proximal sphincteric mechanism or the fistula will not be demonstrated
    • Cystoscopy.
      • Useful to evaluate for concurrent abnormalities of the bladder and urethra.
  • Therapy
    • Catheter drainage
      • Useful in a limited number of cases if the fistula is noted promptly.
    • Transvaginal surgical excision

References

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